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Influence of a distraction task on pelvic floor muscle contraction

Authors

  • Thibault Thubert,

    Corresponding author
    1. Neuro-Urology Department, Tenon Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
    2. GMC-UPMC 01, GREEN, Group of Clinical Research in Neuro-Urology, University Pierre and Marie Curie, Paris, France
    3. Service de gynécologie obstétrique et biologie de la reproduction, APHP, Hopital Antoine Béclère, Clamart, France
    • Correspondence to: Thibault Thubert, M.D., M.S., Service de Neuro urologie Hôpital Tenon 4 rue de la chine, Paris 75020, France. E-mail: thibault.thubert@gmail.com

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    • Medical Doctor.
  • Xavier Deffieux,

    1. GMC-UPMC 01, GREEN, Group of Clinical Research in Neuro-Urology, University Pierre and Marie Curie, Paris, France
    2. Service de gynécologie obstétrique et biologie de la reproduction, APHP, Hopital Antoine Béclère, Clamart, France
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    • Doctorate of Medicine and Philosophy.
  • Marylène Jousse,

    1. Neuro-Urology Department, Tenon Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
    2. GMC-UPMC 01, GREEN, Group of Clinical Research in Neuro-Urology, University Pierre and Marie Curie, Paris, France
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    • Medical Doctor.
  • Amandine Guinet-Lacoste,

    1. Neuro-Urology Department, Tenon Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
    2. GMC-UPMC 01, GREEN, Group of Clinical Research in Neuro-Urology, University Pierre and Marie Curie, Paris, France
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    • Medical Doctor.
  • Samer Sheik Ismael,

    1. Neuro-Urology Department, Tenon Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
    2. GMC-UPMC 01, GREEN, Group of Clinical Research in Neuro-Urology, University Pierre and Marie Curie, Paris, France
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    • Medical Doctor.
  • Gérard Amarenco

    1. Neuro-Urology Department, Tenon Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
    2. GMC-UPMC 01, GREEN, Group of Clinical Research in Neuro-Urology, University Pierre and Marie Curie, Paris, France
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    • Doctorate of Medicine and Philosophy.

  • Heinz Koelbl led the peer-review process as the Associate Editor responsible for the paper.
  • Conflict of interest: none.

Abstract

Aims

Attention may play a key role in the contraction of pelvic floor muscles in stressful situations, meaning that mental distraction may be involved in urinary incontinence.

Methods

Informed consent was obtained from 20 healthy volunteers. The electromyographic (EMG) activity of the external anal sphincter (EAS) was recorded during voluntary contraction elicited by local stimulation. The trials were carried out twice: combined (or not) with a mental distraction task (PASAT), Paced auditory serial additional test. Reaction time, latency between the stimulus and maximum EAS EMG activity, duration of the contraction, maximum EAS EMG activity, and the area under the EAS EMG activity curve were measured.

Results

The mental distraction task led to a 3.98 times greater reaction time (RT), (P = 0.00001 Wilcoxon's test). The RT increased from 217 (IQR: 170–270) to 779 msec (IQR: 550–1,025, P < 0.0001) when the EAS contraction was combined with PASAT. However, the maximum EAS EMG activity was weaker during PASAT than in the absence of a mental distraction task: 0.0850 mv versus 0.0701 mv, that is, 1.21 times weaker (P = 0.00077, Wilcoxon's test). Finally, when the two conditions (respectively with and without the mental distraction task) were compared, no significant difference was found in the area under the EAS EMG activity curve (0.0157 mv sec vs. 0.0162 mv sec, ratio 1.01, P = 0.52).

Conclusions

The mental distraction task altered voluntary contraction of the pelvic floor muscles. Neurourol. Urodynam. 34:139–143, 2015. © 2014 Wiley Periodicals, Inc.

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